Arkansas Model Electronic Data Interchange Trading Partner Agreement

State:
Multi-State
Control #:
US-CP1020-AM
Format:
Word; 
Rich Text
Instant download

Description

This sample form, a detailed Model Electronic Data Interchange Trading Partner Agreement document, is for use in the computer, internet and/or software industries. Adapt to fit your circumstances. Available in Word format.
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FAQ

How do I become a provider? All interested transportation providers must complete and submit a Request for Qualifications Form, as well as driver and vehicle lists. Verida will review applications to determine if there is a need for new transportation providers in the region where the applicant is located.

If you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or (800) 457-4454. When prompted, select 0 for ?Other Inquiries,? then option 3 for ?Provider Enrollment.? We've created a step-by-step video guide to walk you through the online provider enrollment process.

The Toll-Free Telephone Helpline, 1-800-275-1131, operates Monday through Friday am to pm. ConnectCare Helpline Specialists assign or change PCPs at the request of Medicaid and ARKids First beneficiaries.

The Non-Emergency Transportation (NET) Program can give you a ride to and from your doctor appointments or other covered Medicaid services. You do not have to pay anything and there is no limit on the number of trips or miles you can travel.

If you are interested in becoming an MTP provider, you can enroll through the Provider Enrollment and Management System (PEMS). MTP providers may access PEMS to enroll, reenroll, and revalidate with HHSC.

Hear this out loud PauseIf you have questions about how to enroll, call Arkansas Medicaid Provider Enrollment at (501) 376-2211 or toll free at (800) 457-4454. When prompted, select 0 for ?Other Inquiries?, then option 3 for ?Provider Enrollment?.

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Arkansas Model Electronic Data Interchange Trading Partner Agreement